Patient-Reported Outcome and Experience Measures (PROM/PREM) in Patients Undergoing Liver Surgery with Enhanced Recovery after Surgery (ERAS(®)): An Exploratory Study

接受肝脏手术并采用加速康复外科(ERAS®)方案的患者报告结局和体验指标(PROM/PREM):一项探索性研究

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Abstract

BACKGROUND: ERAS(®) (Enhanced Recovery after Surgery) is an evidence-based multidisciplinary approach focusing on optimizing outcomes after surgery through structured clinical pathways. This study aimed to assess patient-reported outcome and experience measures (PROM/PREM), which are not routinely assessed after liver surgery within an ERAS(®) protocol. METHODS: Routine outcome parameters were extracted from clinical documentation. Using qualitative content analysis, PROM and PREM were retrospectively identified in 13 case records. In a prospective survey of 10 participants, PROM was assessed at three timepoints using the EQ-5D-5L questionnaire. PREM were collected at discharge. RESULTS: The following PROM categories occurred in the retrospective content analysis: appetite (84.6%), pain/discomfort (76.9%), mobility (69.2%), wound condition (69.2%), and weight (61.5%). The categories of continuity of care (92.0%) and information, communication, education (69.0%) emerged as PREM. Descriptive changes in health state were shown for all EQ-5D-5L dimensions and timepoints. At discharge, mobility, selfcare, usual activities, and pain/discomfort tended to be worse, whereas anxiety/depression decreased gradually from preoperatively to the 4 week follow-up. There was high satisfaction with interprofessional care services and experienced cooperation between professionals. CONCLUSIONS: PROM and PREM are helpful to incorporate patients' perspectives after liver surgery within an ERAS(®) pathway and should be collected routinely in clinical practice.

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